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New Hampshire rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $1,413 · 10th–90th $117–$8,9130%10%10th90th$1,413$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $323.59 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $177.83
Well Sense
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21